HomeMy WebLinkAbout02-1136PETITION FOR PROBATE and GRANT OF LETTERS
Estate of .~ e h v~ C, ~t"t c~ K
also known as
Deceased.
Social Security No. 1 Cf SS-03 -- q~ ~ ~_
No. 2i-oz- -~ac~
To:
Register of Wills for the
County of CUMBERLAND in the
Commonwealth of Pennsylvania
The petition of the undersigned respectfully represents that:
Your petitioner(s), who is/are 18 years of age or older an the execut ~. Uc1N ~'e ~S ~ named
in the last will of the above decedent, dated , 19
and codicil(s) dated ?`3~- ~ - i R'
(state relevant circumstances, e.g. renunciation, death of executor, etc.)
Decendent was domiciled at death in b -~,~ 1 Gc County, Pennsylva ia, wit
h + .S last family or principal residence at (.t.)CZ ~ i Cr, w G ,
at
~-I~ ~~,-
Except as follows, decedent did not marry, w'as not divorced ancf did not have a child born or adopted
after execution of the will offered for probate; was not the victim of a killing and was never adjudicated
incompetent:
Decendent at death owned property with estimated values as follows:
(If domiciled in Pa.) All personal property
(If not domiciled in Pa.) Personal property in Pennsylvania
(If not domiciled in Pa.) Personal property in County
Value of real estate in Pennsylvania
situated as follows:
5 ~O, `t'Z~C G
WHEREFORE, petitioner(s) respectfully request(s) the probate of the last will and codicil(s)
presented herewith and the grant of letters tes{~~~'n~c-w
(testamentary; administra ion c.t.a.; administration d.b.n.c.t.a.)
theron.
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OATH OF PERSONAL REPRESENTATIVE
COMMONWEALTH OF PENNSYLVANIA ~ ss
COUNTY OF CUMBERLAND
The petitioner(s) above-named swear(s) or affirm(s) that the statements in the foregoing petition are
true and correct to the best of the knowledge and belief of petitioner(s) and that as personal represen-
tative(s) of the above decedent petitioner(s) will well and my administer the estate according to law.
v
Sworn to or affirmed and subscribed ~ ~ t~- - ~'°~/ r .1k-~~! z„
before me this _ 13th day of _ oc'
DECEMBER 2 0 0 2 ~~[x
egister
0
~n
(list street, number and muncipality)
No. 2~ - oa- iia~
Estate of JOHN C TASEK ,Deceased
DECREE OF PROBATE AND GRANT OF LETTERS
AND NOW DECEMBER 13 , 2002 x~ , in consideration of the petition on
the reverse side hereof, satisfactory proof having been presented before me,
IT IS DECREED that the instrument(s) dated 8 - 2 4 -19 8 8
described therein be admitted to probate and filed of record as the last will of
JOHN C TASEK
and Letters TESTAMENTARY '
are hereby granted to E. JAN I E T A S E K
FEES
Probate, Letters, Etc.......... $ 115.0 0
Short Certificates( ) .......... $ 12.0 0
~~~~ extra, pages $ 6 .00-
~cp $ 10.00
TOTAL $ 143.00
FIIed _ 12-13,-2002,,, _..
mail to exec 12-13-2002
Register of Wi
ATTORNEY (Sup. Cc. I.D. No.)
ADDRESS
PHONE
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"I~his is to cerri~~ that the inEc~rrmation here ~lvel: is rorLti.L~~ ~ tr .-.. ~Fi'rP, .. .. - .
Local R-c~lsuar. The ongdr.al ce~ttticate will be f~,r;varc'c!i t+.l r3~.• ~.~ ~ 4 ~~ '~ ,- ) ,.
WARNING; It is illegal #o d~tpliC~E~ YrTI~ ,ar~~sy =~~ I°I .~. -:~ ~s ~ -
hL'e hJr this cc(ri~i~ate, ~Z.O{)
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COMMONW EALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS
CERTIFICATE OF DEATH
ATH ,MCnm Day Zan
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SEX SGCIAL SECURITY NUMBER DATE F
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NAME OF DECEDENT IFuv Mitlde. Leal
John C. Tasek ,. Male ,- 198 - 03 - 9933 .. (~I/P}yt
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AGE:l asl e~nn°ayl UNDER 1 YEAR UNDER 1 DAV DATE OF BIRTH BIrrTHPIACE (Cay and PLACE OF DEATH IChecx only me-- see ~n9lrur.LOr~s nn ahei sx)el .. _. __
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COUNTY OF DEATH CT', BORO. TWP OF DEATH FACILITY NAME UI nd ~nv~WUUn. gwe Weer antl riumow~ WAS DECEDEM OF HISPANIC ORIGIN? RACE American Indan, Blacx, WnKa. etc.
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DECEDENT'S USUAL OCCUPA710N HIND OF BUSINESS/INDUSTRV WAS DEC DENT EVERIN DECEDENT'S EDUCATION MARITAL STATUS~Marr,atl SURVIVING SPOUSE
U. S. ARMED FORCES? onl ni oast ratle com etl Navel MUriaG. Witlowad Jl mle. yew mearan name)
(Goa x~na d vwx tlorre tlurag mass Elsmemaryy$acontlary Colregs DivorcaE (SpenNl
°'""""""""°°"°'°"ieWa°) Trans ortation Y••~"°^ (0-12) oads.' Married Janie Favinger
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DECEDENT'S MAILING ADDRESS ($11M,CeYRwvn.Srere.Zq Cptlel DECEDENT'S Pennsylvania Oq 170.1-RV.s.ExaASrt liw0ln Lower Allen _..__ r.p
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Camp Hill I
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FATHER'S NAME (f x9, Mende. Lag)
Alexander Tasek a~Oen
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S NAME (fxsl. Mitltlb.
MOTHER
,a Katherine Mitchele
IS. INFORMANT'S MAILING ADDRESS IStreal. DiNROwn, SN1e. LD Cotlel
INFORMANT'S NAME (TyperPnnq
Janie Tasek
8 Wa ne Circle Cam Hill, Pa. 17011
GATE OF DISPOSITION ,D~.
PLACE OF DISPOSITION-Nama or Camalsry. Cramalory LOCATION~CiNR ,S1ata.Zp Cona
METHOD OF DISPOSITION
(MOnm. pay. Year)
e cr.mat~^xR.movall,ansrere^ ^ or DIMr Plau
ConoliteCremato Schaefferstown, Pa. 17088
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Donann^ r(s M Nov 23, 2002
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' SIGNATU OF J1N L EL ENSEE OR PE ACTING AS SUCH LICENSE NUMBER NAME MDADDRESS OF FACILITY
M ers Funeral Home Inc. 37 East Main Street Mechanicsbur Pa 1705
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2 LICENSE NUMBER DATE SIGNED
Dom la ilamf 27AC only wnM Unilylrq b IM Mal of my emw tllam rrW a1 IM nma. Sale aM preca Srelen (Mmm. Ody. Yearl
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~/T e~Y WAS CASE REFERRED TO MEDI~CiAL EXaA.M~INERICORONER7
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PART 1: Enter lna dlaaaSaa, injuries or cpmpacelgna wnich DausetllMtlasln Dp rwt emerlM motleof tlyirg,sucnas cardiac orrespnaloryarreal, snpcs ormarl lailun. IApproxirrwu PANT II: Dinar sgniScaM COndeona oodrlWlinq to naaN.WI
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DATE OF INJURY TIME OF INJURY INJ URY AT WORK? DESCRIBE HOW INJURY OCCURRED.
wA5 AN AUTOPSY WERE AUTOPSY FINDINGS MANNER OF DEATH (Mw1m Day. Yeah
PERFORMED? AVAIUBLE PRNM TD
COMPLETION Of CAUSE (]
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SIGNATURE ANDT OF
CERTIFIER Checx ony unel
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NAME AN ADDR
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• 'MEDICAL E%AMINER/CORONER tlesth occurred al lne lime, tlala, and place, antl tlualo lne cauaa(s) ^
On in<hasis of •aaminallon and/or bvesllgahon, in my opinion,
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~~st ~i11 ~n~ C~P~t~cmP~
OF
JOHN C. TASEK
2,1-02- 11310
I, JOHN C. TASEK, of Lower Allen Township, Cumberland
County, Pennsylvania, make, publish and declare this as and for my
Last Will and Testament, hereby revoking all other Wills and
Codicils heretofore made by me.
FIRST: I devise and bequeath all the rest, residue and
remainder of my estate of whatever nature and wherever situate,
including any property over which I hold power of appointment and
together with any insurance policies thereon, unto my wife, E.
JANIE TASEK, provided she survives me by sixty (60) days.
SECOND: Should my wife, E. Janie Tasek, predecease me
or die on or before the sixty-first (61st) day following my death,
I devise and bequeath all the rest, residue and remainder of my
estate of whatever nature and wherever situate, including any
property over which I hold power of appointment and together with
any insurance policies thereon, in equal shares, to my son, JOHN
C. TASEK, JR and my step-son, EARL M. HENRY, JR. If John C.
Tasek, Jr. predeceases me, I direct that his share under this, my
Last Will and Testament, pass directly to EARL M. HENRY, JR. If
Earl M. Henry, Jr. predeceases me, I direct that his share under
this, my Last Will and Testament, pass directly to JOHN C. TASEK,
JR.
THIRD: In addition to all powers granted to them by law
and by other provisions of this Will, I give the fiduciaries
acting hereunder the following powers, applicable to all property,
exercisable without court approval and effective until actual
distribution of all property:
(A) To sell at public or private sale, or to lease, for
any period of time, any real or personal property and to give
I
options for sales, exchanges or leases, for such prices and upon
such terms (including credit, with or without security) or
-°-conditions as are deemed proper. This includes the power to give
legally sufficient instruments for transfer of the property and to
receive the proceeds of any disposition of it.
(B) To partition, subdivide, or improve real estate and
to enter into agreements concerning the partition, subdivision,
improvement, zoning or management of real estate and to impose or
extinguish restrictions on real estate.
(C) To compromise any claim or controversy and to
abandon any property which is of little or no value.
(D) To invest in all forms of property, including
stocks, common trust funds and mortgage investment funds, without
restriction to investments authorized for Pennsylvania fiduci-
aries, as are deemed proper, without regard to any principle of
diversification, risk or productivity.
(E) To exercise any option, right or privilege granted
in insurance policies or in other investments.
(F) To exercise any election or privilege given by the
Federal and other tax laws, including, but not necessarily being
limited to, personal income, gift and estate or inheritance tax
laws.
(G) To make distributions to my herein named benefici-
aries in cash or in kind or partly in each.
(H) To borrow money from themselves or others in order
to pay debts, taxes, or estate or trust administration expenses,
to protect or improve any property held under my will, and for
investment purposes.
(I) To select a mode of payment under any qualified
retirement plan (pension plan, profit sharing plan, employee stock
ownership plan, or any other type of qualified plan) to the extent
the plan or the law permits them to do so, and to exercise any
other rights which they may have under the plan, in whatever
manner they consider advisable.
FOURTH: I direct that all inheritance, estate,
transfer, succession and death taxes, of any kind whatsoever,
which may be payable by reason of my death, whether or not with
2
respect to property passing under this Will, shall be paid out of
the principal of my residuary estate.
FIFTH: All interests hereunder, whether principal or
income, which are undistributed and in the possession of the
fiduciaries acting hereunder, even though vested or distributable,
shall not be subject to attachment, execution or sequestration for
any debt, contract, obligation or liability of any beneficiary,
and furthermore, shall not be subject to pledge, assignment,
conveyance or anticipation.
SIXTH: I nominate and appoint my wife, E. JANIE TASEK,
Executrix of this, my Last Will and Testament. In the event of
the death, resignation or inability to serve for any reason
whatsoever of the said E. Janie Tasek, I nominate and appoint JOHN
C. TASEK, JR. and EARL M. HENRY, JR., or the survivor thereof,
Executor of this, my Last Will and Testament. I direct that my
Executrix or Executor, as the case may be, and their successors,
shall not be required to post security or a bond for the
performance of their duties in any jurisdiction.
IN WITNESS WHEREOF, I have hereunto set my hand and seal
to this, my Last Will and Testament, this ~~ day of ~~;~G%~ ,
1988.
r ~ ~1
s' y~~~, c~.~. ( SEAL )
Joh/, C . Tasek
Signed, sealed, published and declared by the above-
named Testator as and for his Last Will and Testament in our
presence, who, at his request, in his presence and in the presence
of each other, have hereunto subscribed our names as attesting
witnesses.
Address
Address
- ,
:, .
a"
t
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3
REGISTER OF
OATH
(each a subscribin witness to
law, de se(s) and sa )that _
the testat ,sign the'~a~
re est of testat in h_
othe ubscribing 'tness(es)).
orn to r affirmed d sub
me `phis
LLS OF
~ SUBS(
G VV'~,~'NESS
LINTY
codicil
will presented rewith, (each) eing duly q lified
pr
and that igned as a
_ presence nd (in the presenc of each other) 'n the p
ib before
y of ( ame)
19
(Addre
Register
(Name)
(Address)
REGISTER OF WILLS OF cLUrl~erland COUNTY
OATH OF NON-SUBSCRIBING WITNESS
21-0~.- It3to
(each) a subscriber hereto, (each) being duly qualified according to law, depose(s) and say(s) that
THEY ARE familiar with the signature of T.,urT r TASEK ,
codicil
testat OR of (one of the subscribing witnesses to) the will odicil ted herewith and
that THEY believes the signature on the will is in the handwriting of
~---
JOHN C TASEK ~' ~- ~~ `~~~ ' ~~~~'`'~`~
THEIR lcnowled a and belief. ~ ~ ~ `^ ~ ~ ~~ ~ c' ~
to the best of g
`7j ~2i Cx ~1'~ i/1 C' ~ : v C 1 ~'
Sworn to or affirmed and subscribed before
me this - ~ 3 th day of ~~~ ~ ~!Na\ ~e~ ~ ~ (7a I ~
DECEMBER 2002 xg~x
(Address)
1
Register
rdilyg to
ands w
at the
of the
~ -TVc~u
~ (Name)
ti'
(Address)
~ Sow C ~ i1 ~ ~:u A ~~
CERTIFICATION OF NOTICE UNDER RULE 5.6(al
Name of Decedent: \' ~ , ` ~ ~ ~ I~~Li S
Date of Death: `+ ~ 1 ~ ~~ 2-
r ;~
Will No. 'J ~ I ` L~ Z" ~ , 13 ~ Admin. No. ~ yd ~ ' ~ / ~ 3C-G
To the Register:
I certify that notice of (beneficial interest) estate administration required by Rule 5.6(a) of the Orphans' Court Rules was
served on or mailed to the following beneficiaries of the above-captioned estate on ~~' ~'3° UZ.
Name
J ~i ~ ~ c
Nonce has now been given to al
Date: ~ ~ ~ ~ ~ ~
Address
i r~.c, S" Circe y~cl ^ Ll, `tee,/ ~,r/ ~L'~ Li . ~4 . / 70.5 " 5
~ 3`Il~ ~ ~~at~~ 5t, ~~1~~~1,x f~~: ~S~~y~/
1 persons entitled thereto under Rule 5.6(a) except
Sign~i re
Name ~ ; J G /l ~ P ~ I ~ S ~ ~:-
Address ~ ~}~~,~ ~~ h (~~ vc ~ E'
Telephone (~I Z) ~ ~ ~ ._ ~ 3 ~ '`~~
Capacity: ,~ Personal Representative
Counsel for personal representative
1N RE: IN THE COURT OF COMMON PLEAS OF
ESTATE OF CARL D. FARNER, :CUMBERLAND COUNTY, PENNSYLVANIA
Late of the West Pennsboro Township, :ORPHANS' COURT DIVISION
Cumberland County, Pennsylvania,
Deceased :Estate No: 21-02-0451
DECREE AWARDING REAL ESTATE
AND NOW, this ~~ day of September, 2004 it appearing that the First and Final
Account and Statement of Proposed Distribution of Cheryl Farner Donovan, Executrix of the
Estate and under the Last Will and Testament of Carl D. Farner, deceased, have been duly filed
and advertised according to law and rules of court, and that said Account was duly confirmed
and Statement of Proposed Distribution duly approved by this Court on August 26, 2003; and it
further appearing that said Executrix has proposed in said Statement of Proposed Distribution to
distribute the Decedent's real estate in kind to Cheryl Farner Donovan as residuary beneficiary,
under the above mentioned Last Will and Testament; and said Court having decreed distribution
in accordance with said Statement of Proposed Distribution on August 26, 2003,
IT IS ORDERED, ADJUDGED and DECREED that all right, title and interest of the said
CAL D. FARNER, Deceased, in and to the following described real estate is hereby awarded in
fee:.simple to CHERYL FARNER DONOVAN:
~,,
'- All that certain tract of land situated in the Township of West Pennsboro, County of
~---
~.~_.
~~
Cumberland -and Commonwealth of Pennsylvania, more particularly bounded and described in
..~._
accordariee-with a survey made by Eric L. Diffenbaugh, Registered Land Surveyor, on July 19,
2004, as follows:
Beginning at a P.K. nail in the center of Mount Rock Road (T-325) at line of land now or
formerly of John H. Billman; thence along said latter lands the following two (2) courses and
distances: (a) South 27 degrees 54 minutes 23 seconds East, a distance of 248.15 feet to an iron
pin; and (b) South 33 degrees 57 minutes 52 seconds East, a distance of 13.58 feet to an iron pin;
thence continuing along lands now or formerly of John H. Billman and along lands now or
formerly of Michael and Krista H. Zeigler, North 79 degrees 42 minutes 31 seconds East, a
distance of 149.81 feet to an iron pipe at corner of lands now or formerly of the Church of God
of Newville; thence along said latter lands the following two (2) courses and distances: (a) North
80 degrees 12 minutes 17 seconds East, a distance of 66.36 feet to an iron pin; and (b) South 38
degrees 32 minutes 56 seconds East, a distance of 394.91 feet to an iron pipe at corner of lands
now or formerly of Joseph S. and Maralee Sr. Rook Estate; thence along said latter lands the
following four (4) courses and distances: (a) South 38 degrees 45 minutes 8 seconds East, a
distance of 1,018.62 feet to an iron pin; (b) North 69 degrees 23 minutes 42 seconds East, a
distance of 414.34 feet to a planted limestone; (c) South 41 degrees 28 minutes 35 seconds East,
a distance of 869.09 feet to an iron pin and (d) North 62 degrees 38 minutes 31 seconds East, a
distance of 387.27 feet to an iron pin at corner of lands of Big Spring School District; thence
along said latter lands, South 40 degrees 24 minutes 29 seconds East, a distance of 911.48 feet to
a railroad rail at lands now or formerly of Pennsylvania Power and Light Company; thence along
said latter lands the following two (2) courses and distances: (a) South 85 degrees 6 minutes 27
seconds West, a distance of 1,629.03 feet to a railroad rail, and (b) South 85 degrees 1 minute 23
seconds West, a distance of 1,394.13 feet to an iron pipe at corner of lands now or formerly of
Big Spring Masonic Temple Association; thence along said latter lands, North 36 degrees 17
minutes 37 seconds West, a distance of 354.36 feet to an iron pin at corner of lands now or
formerly of Randy L. Myers and Linda K. Tritt; thence along said latter lands and along lands
now or formerly of John L. and Pamela L. Failor, and lands now or formerly of Merle E. (Jr.)
and Dorothy M. Mizell, and lands now or formerly of Robert C. and Patsy Lee Line, and lands
2
now or formerly of Jeffrey Line, and lands now or formerly of Todd Line, and lands now or
formerly of Pamela Line, North 37 degrees 37 minutes 24 seconds West, a distance of 946.39
feet to an iron pin at lands now or formerly of John T. and Nancy S. Dunsmore, thence along
said latter lands the following two (2) courses and distances: (a) North 57 degrees, 8 minutes 28
seconds East, a distance of 920.02 feet to a railroad spike, said spike being in the gravel portion
of Laughlin Mill Road (T-406); and (b) North 46 degrees 3 minutes 42 seconds West, (in said
Laughlin Mill Road) a distance of 171.20 feet to a railroad spike in said Road, at corner of lands
now or formerly of Clinton Frederick Jr. and Nancy M. Beckner; thence along said latter lands
the following three (3) courses and distances: (a) North 42 degrees 29 minutes 1 second West
(within said Laughlin Mill Road and veering to the west of said Road) a distance of 414.50 feet
to an iron pin beyond the west side of said Road; (b) North 27 degrees 16 minutes 10 seconds
West, veering back to said Road, a distance of 148.20 feet to a railroad spike set over a buried
iron pin in said Road; and (c) South 64 degrees 42 seconds West leaving said Laughlin Mill
Road, a distance of 54.40 feet to an iron pin at lands now or formerly of Newville Water
Company; thence along said latter lands the following two (2) courses and distances: (a) North 2
degrees 7 minutes 7 seconds West, a distance of 201.24 feet into Laughlin Mill Road to a
railroad spike set over a buried iron pin in Laughlin Mill Road; and (b) leaving Laughlin Mill
Road, North 35 degrees 15 minutes 17 seconds West, a distance of 79.15 feet to an iron pin at
lands now or formerly of Borough of Newville; thence along said latter lands the following three
(3) courses and distances: (a) North 67 degrees 46 minutes 4 seconds East, a distance of 33.75
feet to a railroad spike in Laughlin Mill Road; (b) North 17 degrees 13 minutes 56 seconds West
in said Laughlin Mill Road, a distance of 44.67 feet to a railroad spike; and (c) North 25 degrees
20 minutes 24 seconds West, still within Laughlin Mill Road, a distance of 42.67 feet to a
railroad spike in said Road at corner of lands now or formerly of William I. Lehman; thence
along said latter lands, North 70 degrees 23 minutes 47 seconds East, a distance of 235 feet to an
iron pin at corner of lands now or formerly of William I. Lehman; thence along said latter lands
the following four (4) courses and distances: (a) South 28 degrees 36 minutes 13 seconds East, a
distance of 90 feet to an iron pin; (b) North 70 degrees 23 minutes 47 seconds East, a distance of
88 feet to an iron pin; (c) North 28 degrees 57 minutes 58 seconds West, a distance of 93.63 feet
to an iron pin and (d) North 65 degrees 23 minutes 47 seconds East, a distance of 94.23 feet to a
P.K. nail in Mount Rock Road (T-325); thence in said Mount Rock Road, along lands now or
formerly of Frederick L. and Judy J. Allman, North 89 degrees 57 minutes 35 seconds East, a
distance of 93.87 feet to a P.K. nail in said Road at lands now or formerly of John H. Billman,
the place of BEGINNING.
CONTAINING 104.8728 acres of land.
BEING the remaining portion of that certain larger premises which Carl Devoe Farner,
joined by his wife, Dorothy H. Farner, by their deed dated June 15, 1977, and recorded in the
Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania in Deed Book "F",
Volume 27, Page 950, granted unto themselves. The said Dorothy H. Farner died on Apri122,
1987, survived by her husband, Carl Devoe Farner, also known as Carl D. Farner (the Decedent
from whose Estate this decree originates), in whom title vested absolutely by operation of law as
surviving tenant by the entireties. The said Carl D. Farner, also known as Carl Devoe Farner,
died on Apri122, 2002, leaving a last will and testament which was duly probated on May 8,
2002 in the Office of the Recorder of Wills in and for Cumberland County, Pennsylvania, in
proceedings docketed to Estate No. 21-02-0451, and Letters Testamentary were duly issued to
Cheryl Donovan, the Executrix named hereinabove.
4
IT IS FURTHER ORDERED AND DIRECTED that a certified copy of this Decree shall
be recorded in the Office of the Recorder of Deeds in and for Cumberland County, Pennsylvania,
among the Deeds recorded in said Office, said Decree to be indexed in the Grantor Index for
Deeds against the Estate of CARL D,. FARNER, Deceased, and in the Grantee Index for Deeds
to CHERYL FARNER DONOVAN, pursuant to Section 3536 of the Decedents, Estates and
Fiduciaries Code (20 Pa. C.S. 3536).
By the Court,
CERTIFICATION OF NOTICE UNDER RULE 5.6 (a)
Name of Decedent: John C. Tasek
Date of Death: November 21, 2002
Will No. 21-02-1136 Admin. No.
To the Register:
I certify that notice of estate administration required by
Rule 5.6(a) of the Orphans' Court Rules was served on or mailed
to the following beneficiaries of the above-captioned estate on
December 3, 2002:
Name Address
E. Janie Tasek
Earl M. Henry
John C. Tasek, Jr.
Notice has now been given to all
Rule 5.6(a) except:
None
Date: September 10, 2004
Capacity:
8 Wayne Circle
Camp Hill, PA 17011
1505 Grand View Avenue
Mechanicsburg, PA 17055
3914 Tonto Street
Phoenix, AZ 85044
persons entitled thereto under
One West Main Street
Shiremanstown, PA 17011
(717) 737-8761
Personal Representative
X Counsel for Personal
Representative
EV-I O0 REV-- 1500
OOMMONWB^LTHOPPEN SYLVAN,A INHERITANCE TAX RETURI
DEPARTMENT OF REVENUE
DEPT. 2 0 0t RESIDENT DECEDENT
HARRISBURG, PA 171Z8-0601
~ DECEDENT'SNAME(LAST, FIRST, ANDMIDDLE~NITIAL)
· ~se~ John C.
~ DATE OF DEATH (M M -DD.YEAR) ~ DATE OF BIRTH (MM-DD.YEAR)
/2 /2002 J
~ (iF APPLICABLE) SURVIVING SPOUSE'S NAME (LAST, FIRST, AND MIDDLE ~NITIAL)
~. ~n[e
OFFICIAL USE ONLY
FILE NUMBER
21-02-[136
COUNTYCODE YEAR NUMBER
SOCIAL SECURITY NUMBER
198- 03- 9933
THIS RETURN MUST BE FI LED IN DUPLICATE WITH THE
REGISTER OF WILLS
SOCIAL SECURITY NUMBER
CA P B 4. Limited Estate Future~nterest Compromlse(dateofdeath after
HpRL ·
E P ! O 6. Decedent Died Testate Decedent Maintained a Living Trust
cRAC
T K (Attach copy of Will) (Attach copy of Trust)
KOEs [] 9. LitlgaflonProceedsRecelved ~]15. SpousalPovertyCredJt
(date of death between 12-31-91 and 1 - 1-95)
204-03-2368
(date of dea h
3. RemalnderReturn prlorto 2-13-82)
5. Federal Estate Tax Return Required
8. Total Number of Safe Deposit Boxes
Election to tax under Sec. 9113(A)
(Attach Sch O)
NAME
Jennifer B. Hipp Esquire
IRM NAME App,c,b,e)
TELEPHONE NUMBER
COMPLETE MAILING ADDRESS
One West Main Street
ShiremanstowIt, PA 17011
T
A
X
R
E
C
A
P
!
T
U
L
A
T
I
O
N
C
O
M
T
I
O
N
1. Real ~<tmt~ (Schedule A)
Z. Stocks and Bonds (Schedule B)
3. Closely Held Corporation, Partnership or
Sole-Proprietorship
4. Mortgages & Notes Receivable (Schedule D) (4)
5. Cash, Bank Deposits & Miscellaneous Personal Property (5)
(Schedule E)
6. Jointly Owned Property (Schedule F) (6)
] Separate Billing Requested
7. Inter-Vivos Transfers & Miscellaneous Non-Probate Property (7)
(Schedule G or L)
8. Total Gross Assets (total Lines 1-7}
9. Funeral Expenses & Administrative Costs (Schedule H) (5)
10. Debts of Decedent, Mortgage Liabilities, & Liens (Schedule l) (10)
11. Total Deductions (total Lines 9 & 10)
12. Net Value of Estate (Line 8 minus Line 11)
(1)
(Z) NoKe' :i
(3) No~te
None
56,787.69
None
None
None
None
13. Charitable and Governmental Bequests/Sec 9113 Trusts for which an election to tax has not been
made (Schedule J)
14. Net Value Subiect to Tax (Line 12 minus Line 13)
SEE INSTRUCTIONS ON REVERSE SIDE FOR APPLICABLE RATES
15. Amount of Line 14 taxable at the spousal tax
rate, or transfers under Sec. 9116(a)(1.2) 56,787.69 X .0 0
16. Amount of Line 14 taxable at lineal rate X .0 45
17. Amount of Line 14 taxable at sibling rate X .12
18. Amount of Line 14 taxable at coUateral rate X .15
19. Tax Due
(8)
(11)
(12)
(13).
(14)
(15)
(16)
(17)
(18)
(19)
56,787.69
0.00
56,787.69
56,787.69
0.00
0.00
0.00
0.00
O. O0
Copyright (c) 2000 form software only T he Lackner Group, l nc,
Form REV-1500 EX (Rev. 6-00)
Decedent's Complete Address:
5T~E~ ~ ADDRESS
8 Wayne Circle
CITY
J STATE IZlp
Camp Hill PA 17011
Tax Payments and Credits:
1. Tax Due (Page 1 Line 19) (1) O. O0
Z. Credits/Payments
A. Spousal Poverty Credit
B. Prior Payments
C, Discount
Total Credits ( A + B + C ) (2) 0.00
3. Interest/Penalty if applicable
D. Interest
E. Penalty
Total Interest/PenaEy ( D + E ) (3) 0.00
4. If Line 2 is greater than Line 1 + Line 3, enter the difference. This is the OVERPAYMENT.
Check box on Page 1 Line 20 to request a refund (4) 0.00
5. If Line 1 + Line 3 is greater than Line 2, enter the difference. This is the TAX DUE. (5) 0. O0
A. Enter the interest on the tax due, (SA) 0.00
B. Enter the total of Line 5 + SA. This is the BALANCE DUE. (88) 0.00
Make Check Payable to: REGISTER OF WILLS, AGENT
PLEASE ANSWER THE FOLLOWING QUESTIONS BY PLACING AN "X" IN THE APPROPRIATE BLOCKS
1. Did decedent make a transfer and: Yes No
a. retain the use or income of the property transferred;
b. retain the right to designate who shall use the property transferred or its income; ...........
c. retain a reversionary interest; or ....................................
d. receive the promise for lite of either payments, benefits or care? ...................
2. If death occurred after December 12, 1982, did decedent transfer property within one year of death
without receiving adequate consideration?.
3. Did decedent own an "in trust for" or ~a"a~-' ..... ~ .L. .
or her death? .............................................. []
4. Did decedent own an Individua~ Retirement Account, annuity, or other non-probate property
which contains a beneficiary designation?
IF THE ANSWER TO ANY OF THE ABOVE QUESTIONS IS YES,
YOU MUST COMPLETE SCHEDULE G AND FILE IT AS PART OF THE RETURN.
correct and complete. Declaration of preparer other than the personal representative Is based on alt Information of which p~ ep=~ =r has any knowledge.
SIGNATURE PERSO,N RESPO [BLE FOR FILING RETURN $ o ~Ta~_~.e rasek DATE
S'GNATUREO PRE"A"EROT.ERT.AN REPRESENTAT,VE ;- .........................
u,v,v~ng spouse m .~'o [/z P.S. 9116 {a) (1.1) (i)]. [ne use or me
For dates of death on or after January 1, 1995, the tax rate imposed on the net value of transfers to or for the use of the surviving spouse is 0%
[72 P.S. 9116 (a) (1.1) (ii)]. The statute does not exempt a transfer to a surviving spouse from tax, and the statutory requirements for disclosure of assets
and filing a tax return are still applicable even if the surviving spouse is the only beneficiary.
For dates of death on or after July 1, 2000:
The tax rate imposed on the net value of transfers from a deceased child twenty-one years of age or younger at death to or for the use of a natural
parent, an adoptive parent, or a stepparent of the child is 0% [72 P.S. 9116 (a) (1.2)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's lineal beneficiaries is 4.5%, except as noted in 72 P.S. 9116(1.2)
[72 P.S. 9116(a)(1)].
The tax rate imposed on the net value of transfers to or for the use of the decedent's siblings is 12% [72 P.S. 9116(a)(1.3)]. A sibling is defined, under
Section 9102, as an individual who has at least one parent in common with the decedent, whether by blood or adoption.
Copyrig ht (c) ~000 form software only T he Lackner Group, [nc. Form REV- 1880 EX (Rev. 6-00)
REV- 1508 EX * (1-97)
COMMONWEALTH OF PENNSYLVANIA
INHERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
SCHEDULE E
CASH, BANK DEPOSITS,& MISC.
PERSONAL PROPERTY
FILE NUMBER
John C. Tasek SS~/ 198-03-9933 11/21/2002 21-02-1136
Include the.proceeds of litigat on and the date the proceeds were received by the estate. All property jointly-owned with the right of
survivorship must be disclosed on Schedule F.
iTEM
NUMBER DESCRIPTION
1 AmeriChotce Federal Credit Union - Share savings account
TOTAL (Also enter on line 5, RecapituJation) ~
VALUE AT DATE
OF DEATH
56,787.69
56,787.69
(If more space is needed, insert additional sheets of the same size)
Copyright(c) 1996 form softwareon;y CPSystems, [nc. Form REV-1508 EX (Rev. 1~97)
AmeriCho ce
~ FEDERAL CREDIT UNION
Build/ng Re/at/onsh/ps For Life
August 24, 2004
James D. Bogar
Attorney at Law
One West Main Stxeet
Shiremanstown, PA 17011
RE: Estate of ~ohn C. Tasek
Account #34224
SS #I98-03~9933
The account is as follows:
Account Type Date Opened DOD Balance
Share-Savings-01 06/2002 $ 56,787.69
The account was closed December 23, 2002 for $56,845.71.
Please call me at (717)591-1275 if you need fia-ther assistance.
Sincerely,
Beth M. Yorlets
Head Teller
Dividend Paid to DOD Ownership
$ 243.03 Sole owner
Main Office: 2175 Bumble Bee Hollow Road · Mechanicsburg, PA 17055 · Phone: (717) 697-3474 · Fax: t717) 697-3713
1~ ~ Website: www.americhoice.org
CR]~)IT UNIONS'
REV- 1513 EX * (9-00)
COMMONWEALTH OF PENNSYLVANIA
IN HERITANCE TAX RETURN
RESIDENT DECEDENT
ESTATE OF
John C. Tasek SS~/ 198-03-9933
II.
SCHEDULE J
BENEFICIARIES
11/21/2002
NAME AND ADDRESS OF PERSON(S) RECEIVING PROPERTY
TAXABLE DISTRIBUTIONS [Include outright spousal distributions, and
E. Janie Tasek
8 Wayne Circle
Camp Hill, PA
transfers under Sec. 9116~1.Z)1
17011
RELATIONSHIP TO DECEDENT
Do Not List Trustee(s)
Wife
ENTER DOLLAR AMTS. FOR DISTRIBUTIONS SHOWN ABOVE ON LN. 15 THRU 18,
NON-TAXABLE DISTRIBUTIONS:
A. SPOUSAL DISTRIBUTIONS UNDER SEC. 9113 FOR WHICH AN ELECTION TO TAX IS NOT BEING MADE
B. CHARITABLE AND GOVERNMENTAL DISTRIBUTIONS
FILE NUMBER
21-02-1136
AMOUNT OR SHARE
OF ESTATE
Rest, residue
and remainder
AS APPROPRIATE, ON REV 1500 COVER SHEET
TOTAL OF PART II - ENTER TOTAL NON-TAXABLE DISTRJBUTIONS ON LINE 13 OF REV 1500 COVER SHEET 0.00
(If more space is needed, inselt additional sheets of the same size)
Copyright (c) Z000 form software only The Lack~ler Group, Inc.Form REV-1513 EX (Rev, 9-00)
STATUS REPORT UNDER RULE 6.i2
Name o f Decedent: John C. Tasek
Date of Death:
will No.
November 2 ], 2002
2]-02-1136
Admin. No.
Pursuant to Rule 6.12 of the Supreme Court Orphans'
Court Rules, I report the following with respect to completion of
the administration of the above-captioned estate:
State whether administration of the estate is complet=:
Yes xx Nc ~
2. If the answer is No, state when the personal
representative reasonably believes that the administration will be
complete:
3. If the answer to No. 1 is Yes, state the following:
a. 0id the personal representative file a final
,account with the Court? Yes No XX
O. The separate Orohans' Court No. (if an?,) for
the personal representative's account is:
Oate: c~/i0,/n,4~
0/3
c. Did the personal representative state an
account informally to the parties in interest? Yes 154 No
d. Copies of receipts, releases, joinders and
approvals of formal or informal accounts may be filed with the
Cerk of the Orphans' Court and may be attached to this reoort
Signalere
Jennifer B. Hipp, Esquire
Name (Please ty~e or print~
One West Main ~.
on_~mans~own, PA 17'3!!
Address
/717) 737-$76L
Tel. No.
Capacity:
__Personal Representative
( MAH: rmf/A~M3 )
x
__Counsel for personal
representati
%\~- ~.%~.
BUREAU OF TNDTVTDUAL TAXES
INHERITANCE TAX DIVISION
DEPT. Z80601
HARRISBURG, PA 171Z8-0601
COHHONNEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
NOT/CE OF INHERITANCE TAX
APPRAISEHENT, ALLONANCE OR DISALLOgANCE
OF DEDUCTIONS AND ASSESSMENT OF TAX
REV-I$,~7 EX AFP cD1-05)
JENNIFER 8 HIPP ESQ
I N MAIN ST
SHIREMANSTONN
PA 17LQ1.1
DATE 11-08-200q
ESTATE OF TASEK
DATE OF DEATH 11-21-2002
FILE NUMBER 21 02-1156
COUNTY CUMBERLAND
ACN 101
I Amount Remitted
JOHN C
HAKE CHECK PAYABLE AND REHZT PAYMENT TO:
REGISTER OF NILLS
CUMBERLAND CO COURT HOUSE
CARLISLE, PA 17015
CUT ALONG THIS LINE ~'- RETAIN LONER PORTION FOR YOUR RECORDS ~-~
~-: i ~- - ~- -i ~- - [ ~=-~ ~5- -~ 6~-~ E ~p - ~ ~-~ ~N-~ - ~i- ~ i~-~ ~k~ ¥~- -i ~N~i - ~ .................
DZSALLONANCE OF DEDUCTIONS AND ASSESSHENT OF TAX
ESTATE OF TASEK JOHN CFILE NO. 21 02-1136 ACN 101 DATE 11-08-200q
TAX RETURN gAS: (X) ACCEPTED AS FILED ( ) CHANGED
RESERVATION CONCERNING FUTURE INTEREST - SEE REVERSE
APPRAISED VALUE OF RETURN BASED ON: ORIGINAL RETURN
1. Real Estate (Schedule A) (1)
2. Stocks and Bonds (Schedule B) (2)
3. Closely Held Stock/Partnership Interest (Schedule C) (3)
q. Mortgages/Notes Receivable (Schedule D)
5. Cash/Bank Daposits/Hisc. Personal Property (Schedule E) (5)
6. Jointly Owned Property (Schedule F) (6)
7. Transfers (Schedule G) (7)
8. Total Assets
APPROVED DEDUCTIONS AND EXEHPTIONS:
9. Funeral Expansas/Adm. Costs/Misc. Expenses (Schedule H) (9)
10. Debts/Mortgage Liabilities/Liens (Schedule Z) (10)
11.
12.
15.
NOTE:
.00
.00
.00
.00
56~,787.69
.00
.00
(8)
.00
.00
Total Deductions (11)
Nat Value of Tax Return (12)
Charitable/Governmental Bequests; Non-eXacted 9113 Trusts (Schedule J) (15)
Net Value of Estate Subject to Tax
If an assess.ent ~as 1ssued previously, lines 14, 15 and/or 16,
reflect figures that include the total of ALL returns assessed to date.
ASSESSMENT OF TAX:
15. Amouni: of Line lq st Spousal ra~e
16. Aeount of Line lq taxable at Lineal/Class A rats
17. Aaount of Line lq at Sibling rats
18. Aeount of Line lq taxable at Collateral/Class B rate
19. Princi ~al Tax Due
TAX CREDITS
PAYMENT RECEIPT DISCOUNT (+)
DATE NUMBER INTEREST/PEN pAID (-)
NOTE: To insuFe proper
credit to your account,
subeit the upper portion
of ~his fore with ~our
tax payment.
56,787.69
IF PAID AFTER DATE INDICATED, SEE REVERSE
FOR CALCULATION OF ADDITIONAL INTEREST.
,00
56,787.69
17, 18 and 19 Nill
(is) 56,787.69 x O0 =
(16) .00 X Oq5 =
(17) .00 x 12 =
(18) .00 x 15 =
(19)=
.00
56,787.69
.0O
.00
AMOUNT PAID
.00
.00
.00
TOTAL TAX CREDIT .00
BALANCE OF TAX DUEI .00
INTEREST AND PEN. .00
TOTAL DUE .00
( IF TOTAL DUE IS LESS THAN $1, NO PAYMENT IS REQUIRED.
IF TOTAL DUE IS REFLECTED AS A 'CREDIT' (CR), YOU NAY BE DUE~-~
A REFUND. SEE REVERSE SIDE OF THIS FORH FOR INSTRUCTIONS.)